Medial-Vowel Writing Difficulty in Korean Syllabic Writing: A Characteristic Sign of Alzheimer’s Disease
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Background and Purpose Korean-speaking patients with a brain injury may show agraphiathat differs from that of English-speaking patients due to the unique features of Hangul syllabicwriting. Each grapheme in Hangul must be arranged from left to right and/or top to bottomwithin a square space to form a syllable, which requires greater visuospatial abilities than whenwriting the letters constituting an alphabetic writing system. Among the Hangul grapheme positionswithin a syllable, the position of a vowel is important because it determines the writingdirection and the whole configuration in Korean syllabic writing. Due to the visuospatial characteristicsof the Hangul vowel, individuals with early-onset Alzheimer’s disease (EOAD) mayexperiences differences between the difficulties of writing Hangul vowels and consonants dueto prominent visuospatial dysfunctions caused by parietal lesions. Methods Eighteen patients with EOAD and 18 age-and-education-matched healthy adultsparticipated in this study. The participants were requested to listen to and write 30 monosyllabiccharacters that consisted of an initial consonant, medial vowel, and final consonant with a oneto-one phoneme-to-grapheme correspondence. We measured the writing time for each grapheme,the pause time between writing the initial consonant and the medial vowel (P1), and thepause time between writing the medial vowel and the final consonant (P2). Results All grapheme writing and pause times were significantly longer in the EOAD groupthan in the controls. P1 was also significantly longer than P2 in the EOAD group. Conclusions Patients with EOAD might require a higher judgment ability and longer processingtime for determining the visuospatial grapheme position before writing medial vowels. This findingsuggests that a longer pause time before writing medial vowels is an early marker of visuospatialdysfunction in patients with EOAD.
Abstract
Background and Purpose Korean-speaking patients with a brain injury may show agraphiathat differs from that of English-speaking patients due to the unique features of Hangul syllabicwriting. Each grapheme in Hangul must be arranged from left to right and/or top to bottomwithin a square space to form a syllable, which requires greater visuospatial abilities than whenwriting the letters constituting an alphabetic writing system. Among the Hangul grapheme positionswithin a syllable, the position of a vowel is important because it determines the writingdirection and the whole configuration in Korean syllabic writing. Due to the visuospatial characteristicsof the Hangul vowel, individuals with early-onset Alzheimer’s disease (EOAD) mayexperiences differences between the difficulties of writing Hangul vowels and consonants dueto prominent visuospatial dysfunctions caused by parietal lesions. Methods Eighteen patients with EOAD and 18 age-and-education-matched healthy adultsparticipated in this study. The participants were requested to listen to and write 30 monosyllabiccharacters that consisted of an initial consonant, medial vowel, and final consonant with a oneto-one phoneme-to-grapheme correspondence. We measured the writing time for each grapheme,the pause time between writing the initial consonant and the medial vowel (P1), and thepause time between writing the medial vowel and the final consonant (P2). Results All grapheme writing and pause times were significantly longer in the EOAD groupthan in the controls. P1 was also significantly longer than P2 in the EOAD group. Conclusions Patients with EOAD might require a higher judgment ability and longer processingtime for determining the visuospatial grapheme position before writing medial vowels. This findingsuggests that a longer pause time before writing medial vowels is an early marker of visuospatialdysfunction in patients with EOAD.
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